Mammadkhanli Orkhan, Elbir Cagri, Hanalioglu Sahin, Canbay Suat
Department of Neurosurgery, Medical Park Hospital, Ankara, Turkey. E-mail:
Neurosciences (Riyadh). 2020 Jan;25(1):50-54. doi: 10.17712/nsj.2020.1.20190048.
To investigate the treatment of iatrogenic cerebrospinal fluid (CSF) leak that develops after degenerative lumbar spinal surgery with a subfascial drainage and clipping (SDC) technique.
This study retrospectively reviewed the medical records of 46 patients who developed iatrogenic CSF leak after surgery for lumbar degenerative spine disease from 2007 to 2019. Twenty-five patients were treated with the SDC procedure (SDC group), whereas 21 were not (control group). Outcomes were compared between the two groups.
CSF leakage ceased within 6-9 days (average 7.4+/-1) after the procedure in the SDC group. In the control group, CSF leakage was controlled with conservative measures in 14 patients, and in 7 patients, lumbar external drainage was performed. Among these 7, the CSF leak was controlled by lumbar external drainage in 3, and 4 required reoperation to repair the dural defect. No infection occurred in either group. Length of hospital stay was also shorter in SDC group (8.4+/-1 vs 10.0+/-1.3 days, p less than 0.001).
The SDC technique is effective for the treatment of iatrogenic CSF leak that develops after degenerative lumbar spinal surgery.
探讨采用筋膜下引流及夹闭（SDC）技术治疗退变性腰椎手术后发生的医源性脑脊液漏。
本研究回顾性分析了2007年至2019年因腰椎退变性疾病手术后继发医源性脑脊液漏的46例患者的病历。25例患者采用SDC手术治疗（SDC组），21例未采用（对照组）。比较两组的治疗结果。
SDC组术后6 - 9天（平均7.4±1天）脑脊液漏停止。对照组中，14例患者通过保守措施控制了脑脊液漏，7例患者进行了腰大池引流。在这7例患者中，3例通过腰大池引流控制了脑脊液漏，4例需要再次手术修复硬脊膜缺损。两组均未发生感染。SDC组的住院时间也较短（8.4±1天 vs 10.0±1.3天，p＜0.001）。
SDC技术对于治疗退变性腰椎手术后发生的医源性脑脊液漏有效。
